The complications which may arise College of Health Sciences University of Zimbabwe Department of Obstetrics and Gynaecology Pregnancy is divided into three trimesters Some complications peculiar to trimesters First trimester Week 1 to end of Week 12 Second trimester Week 13 to end of Week 26 Third trimester Week 27 to the end of pregnancy Care during pregnancy Reduces complications to the mother and the baby Identifies both pre-existing diseases and diseases that develop during the course of the pregnancy Interventions can be done early Good forum for educating the expecting mothers on Self care What to expect as pregnancy progresses How to recognise pregnancy complications The following are screened for during the antenatal period locally Anaemia Blood group Urinary tract infection Syphylis HIV infection Diabetes in those at risk Field of feto-maternal medicine growing Screening for foetal abnormalities Placental position Foetal growth Morning Sickness Hyperemesis gravidarum Excessive vomiting Loss of weight Loss of muscle mass Electrolyte imbalance Lower abdominal discomfort and pain Stretching of the ligaments that support the uterus Miscarriage Lower abdominal pain Bleeding Bleeding might be with clots Ectopic pregnancy Pregnancy implanted in the fallopian tube Fallopian tube eventually ruptures Bleeding into the abdomen Molar pregnancy Abnormal placental tissue Lower abd pain, bleeding Urinary tract infection Frequency of urination Burning pain on urination May be blood in the urine Candidiasis Fungal infection Whitish discharge Has curds Causes itchiness and burning sensation on the vulva Second/third trimester Leading cause of complications in pregnancy Maternal complications Neonatal complications Among the leading causes of maternal death worldwide Raised blood pressure before 20 weeks Chronic hypertension Raised blood pressure after 20 weeks Gestational hypertension Pre-eclampsia – Hypertension associated with loss of protein in the urine Eclampsia – Associated with fits Symptoms of impending fits in severe hypertension in pregnancy Headache Blurring of vision Pain in the upper part of the abdomen Hypertension in pregnancy as above Pre-labour preterm rupture of the membranes Draining of amniotic fluid before 37 weeks Risk of infection Risk of prolapse of the cord Bleeding before the beginning of labour Placenta praevia (low-lying placenta) Placental abruption (premature separation of the placenta) Rarely bleeding may be due to cancer Prelabour rupture of the membranes at term Draining amniotic fluid at term Risk of maternal and neonatal infection Risk of prolapse of the umbilical cord Premature labour 7 – 12% of pregnancies Infection might be a trigger Baby prone to complications of prematurity Infection Respiratory distress Jaundice Hypothermia Electrolyte imbalances Foetal distress Failed progress Obstructed labour Ruptured uterus Postpartum haemorrhage Responsible for 25% of maternal deaths annually worldwide Atonic uterus Retained products Trauma to the genital tract Coagulation abnormalities Puerperal sepsis Premature rupture of membranes Premature labour Inadequate aseptic technique Assisted vaginal delivery Caesarean section
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